CASE PRESENTATION

HISTORY 43y, healthy, caucasian, female PC: L red painful eye 1/52 GMH: pleurisy 3y ago Medication: nil Allergies: nil POH: nil

CLINICAL EXAMINATION VA: R and L 6/6 PERL R: NAD L: injected ccc cornea: v cells: ++ flare:+ IOP: 12 Fundus: NAD (? Dilated) IMP: L acute iridocyclitis PLAN: g Maxidex qds, g cyclo 1% nocte/ 2/52 FU

1/52 after: L  VA VA: R 6/6 L 6/12 L RAPD ISHIHARA: R 17/17, L 1/17 Cornea: fine KP A/C: ++ IOP: R13, L 15 VIT: few cells/ minimal haze FUNDUS: L blurred disc margins Multiple white choroidal spots/ temporal Few haem., no sheathing

IMP: panuveitis/ neuroretinitis PLAN: g Maxidex hourly, g Cyclo 1% tds, oc Maxitrol INVESTIGATIONS FBC, ESR, CRP, U+E, LFT SERUM ELECTROPHORESIS ACE, Ca, CXR RF, ANA, ANCA HLA A-29, B-5, B-27 VDRL/ LYME SEROLOGY FU 1/7

NEXT DAY FU VA: L 6/18 ISQ + RETINAL VASCULITIS ACE 61 ALP 151 GLC 8.1 ESR: 25 CRP: 10 REST NORMAL REFFERED TO MEH

Diagnosed ARN IV Aciclovir LASER Other eye not affected MEH